Author: Richard Lusimbo. PHOTO/FIFLE/COURTESY
As we commemorate the 16 days of activism and World Aids Day, it is critical to reflect on the key insights provided by the recent Bio-Behavioural Survey, which was carried out by Makerere School of Public Health with the support of the Ministry of Health, PEPFAR, and the CDC and published in the Daily Monitor on October 19th. The findings, which reveal a concerning increase in HIV infections among sex workers in Uganda, highlight a widespread issue that affects the entire spectrum of our society.
The survey findings are not isolated events; they are part of a larger narrative that has received extensive media coverage regarding the rise in HIV infections across diverse groups. This developing trend necessitates a thorough examination of our current strategies, as well as a renewed commitment to stemming.
But first, we must applaud the Government of Uganda, the Ministry of Health, the Uganda Aids Commission, and other development partners for their unwavering commitment to lowering HIV infections. Significant progress has been made thanks to effective campaigns and the availability of vital health commodities, including contraception, pre-exposure prophylaxis (PrEP), and post-exposure prophylaxis (PEP). However, the continuing high infection rates in underprivileged populations highlight the urgent need to expand the scope of these activities.
Initiatives like the Presidential Initiative on Aids Strategy for Communication to Youth (PIASCY) have been crucial in educating young people in schools about HIV prevention and management. Digital platforms such as the SautiPlus App by Reach A Hand Uganda and initiatives like 'Protect the Goal' by the Uganda AIDS Commission in collaboration with Unaids continue to encourage safe sexual behaviours among young people. Furthermore, the Ministry of Health's Consolidated HIV Prevention Guidelines and ongoing epidemiological surveillance enhance the strategic response to HIV by providing up-to-date data for targeted interventions.
Providing access to accurate information and essential health services for key and vulnerable populations, such as sex workers, must be a cornerstone of our national HIV response strategy. These groups often bear the brunt of stigma and discrimination, which not only marginalises them but also severely impedes their access to necessary health interventions. For over two decades now, working in civic society, I've personally seen the enormous obstacles that sex workers endure.
Many are subjected to abuse and exploitation, which frequently goes unreported and ignored, increasing the risk of HIV transmission. The lack of legal recourse and assistance for them is a glaring flaw in our fight against HIV/Aids. This is exacerbated by restrictive policies and legislation, such as the Anti-Homosexuality Act and Sexual Offenses Bill that was recently tabled in Parliament, which further isolate crucial communities from the resources they sorely require.
These policies not only increase the vulnerability of the key and vulnerable populations to HIV, but they also generate an environment that encourages discrimination and stigma. It is vital to realise that effective HIV prevention and treatment are inextricably linked with human rights. As a result, our approach must be inclusive and accepting of the rights of all people, regardless of occupation, sexual orientation and gender identity.
To move forward, we must implement bold policy and practice reforms. To improve access to complete health treatments, PrEP, PEP, and other preventative measures must be made available to all high-risk groups while ensuring they are not discriminated against when receiving these services. We must also strengthen information and education initiatives by launching focused information campaigns that reach out to them with culturally and contextually appropriate material that successfully informs them of their health options and rights.
Reforming discriminatory laws is critical; we must reevaluate laws and policies that disproportionately affect vulnerable populations, with a focus on repealing or amending legislation such as the anti-homosexuality act and revisiting provisions in the sexual offences bill to ensure they protect rather than punish. Supporting community-driven initiatives entails supporting projects led by the communities most impacted by HIV, enabling them with funding and capacity building to conduct advocacy and health education campaigns.
Therefore let this not only be a moment of reflection but also a call to action. It is incumbent upon us—government officials, healthcare providers, civil society, and all stakeholders—to adopt a more inclusive approach that addresses the needs of all citizens, particularly those at the margins. Only by working together, with empathy and determination, can we hope to overcome the dual challenges of HIV and societal inequality.
Mr Richard Lusimbo is the director general
of the Uganda Key Populations Consortium
